Lynne Theophanis, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

091712 Issued in NY

Practice address

38 Riverside Dr Ste 3
Binghamton, NY 13905-4596

Phone

(607) 215-1705

NPI assigned

Dec 15, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1821757055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 FRONT ST",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501513",
            "telephone_number": "607-321-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 RIVERSIDE DR STE 3",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054596",
            "telephone_number": "607-215-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOPHANIS",
        "first_name": "LYNNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "091712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MASTER SOCIAL WORKER",
            "identifier": "091712",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltheophanis@psychiatry.life",
            "affiliation": "N",
            "endpointDescription": "ltheophanis@psychiatry.life",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "38 Riverside Dr Ste 3",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139054596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Social Worker in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.